| NPI | 1841494341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK WINSLOW ICARD Dentist 704-455-5003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: NC 5668) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |